Form 0920-1072 SSuN Data Elements

STD Surveillance Network (SSuN)

Revision Request

SSuN Data Elements

Attachment 5

OMB# 0920-1072

May 12, 2023

	OMB Control# 0920-1072 (Expires XX/XX/XXXX)
DE #	Data Element Name	Description/Response Coding
Strategy A (STD Clinic) Data Elements
1	F1_FacilityID	Unique facility identifier
		This ID should be supplied by the site and is a unique facility identifier from underlying surveillance systems or may be generated specifically for SSuN. Regardless of source, this ID must be unique and allow for longitudinal tracking of the facility. This data element MUST NOT be ‘null’ or contain missing values.
2	F1_SiteID	Unique site code
		BA=Baltimore (Cycle II, Cycle III, Cycle IV)
		CB=Columbus Ohio (Cycle IV)
		CA=California (Cycle II, Cycle III, Cycle IV)
		FL=Florida (Cycle III & Cycle IV)
		IN=Indiana (Cycle IV)
		MC=Multnomah County (Cycle III &Cycle IV)
		NY=New York City (Cycle II, Cycle III, Cycle IV)
		PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
		SF=San Francisco (Cycle II, Cycle III, Cycle IV)
		WA=Washington (Cycle II, Cycle III, Cycle IV)
		UT=UTAH (Cycle IV)
		LA=Louisana (Cycle II)
		VA=Virginia (Cycle II)
		AL=Alabama (Cycle II)
		CO=Colorado (Cycle II)
		CH=Chicago (Cycle II)
		MA=Massachusetts (Cycle III)
		MN=Minnesota (Cycle III)
		This data element MUST NOT be ‘null’ or contain missing values.
3	F1_PatientID	Unique patient identification number assigned by site
		This ID should be supplied by the site and may be a unique patient identifier from underlying surveillance systems or may be generated specifically for SSuN. Regardless of source, this ID must be unique and allow for longitudinal tracking of patients within facilities. This data element MUST NOT be ‘null’ or contain missing values.
4	F1_Visdate	Date of clinic visit
		This data element MUST NOT be ‘null’ or contain missing values except for HIV eHARS lab match records.
5	F1_EventID	Unique visit identification
		This record ID should be supplied by the site and may be an event or visit ID assigned at the clinic level
6	F1_sex_Birth	What is the patient’s assigned sex at birth?
		1= Male
		2= Female
		3=Intersex
		4=Unknown
		9=Not Captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the facility or is not provided to SSuN.
7	F1_Gender_Identity	What is the patient's gender identity?
		1= Male
		2= Female
		3=Transgender M to F
		4=Transgender F to M
		5=Transgender, Unknown or Unspecified
		6= Gender Queer/Non-Binary
		7= Other
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
8	F1_Age	How old is this patient? (Age in years).
		If age is unknown or missing, use null value.
		For the following race/ethnic questions below: Indicate yes for all of the race/ethnic questions that apply. A response of 9 indicates the information is not captured/ collected by the facility or is not provided to SSuN. Response should be null if (1) race is collected by the facility but is unknown for this record, or (2) a response of “no” is not collected separately.
9	F1_Hisp	Is the patient of Hispanic ethnicity?
		1= Yes
		2= No
		9= Not captured
10	F1_AIAN	Is the patient American Indian or Alaskan Native?
		1= Yes
		2= No
		9= Not captured
11	F1_Asian	Is the patient Asian?
		1= Yes
		2= No
		9= Not captured
12	F1_PIH	Is the patient Native Hawaiian or Pacific Islander?
		1= Yes
		2= No
		9= Not captured
13	F1_Black	Is the patient Black?
		1= Yes
		2= No
		9= Not captured
14	F1_White	Is the patient White?
		1= Yes
		2= No
		9= Not captured
15	F1_Multirace	Is the patient Multirace?
		1= Yes
		2= No
		9= Not captured
16	F1_Otherrace	Is the patient another race not listed above?
		1= Yes
		2= No
		9= Not captured
		Indicate yes for all of the race/ethnic questions that apply. A response of 9 indicates the information is not captured/ collected by the facility or is not provided to SSuN. Response should be null if (1) race is collected by the facility but is unknown for this record, or (2) a response of “no” is not collected separately.
17	F1_Insurance	What is the primary health insurance status of the patient (regardless of whether it is used for the clinic visit)?
		1= Insured, Public only
		2= Insured, Private only
		3= Insured, Multiple types
		4=Unknown type
		5=Uninsured
		9= Insurance status not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected but is unknown for this record.
18	F1_Visit_type	Type of clinic visit
		1 = Clinician
		2= express/fast track
		3=Telemedicine - Clinician Visit
		4=Telemedicine - Express Visit
		8= Other
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or not provided to SSuN. A response of null indicates that the information is collected but is unknown for this record.
19	F1_Reason_visit	What was the primary purpose of the visit?
		1= Symptomatic/new problem
		2= Treatment only/Positive STD Test
		3= Follow-up
		4= Family planning(retired)
		5= STD/HIV screening only
		6= Prenatal care (retired)
		7=PrEP Visit
		8= Other
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. The response options 4 and 6 are no longer to be used but left here for historical purposes. Although multiple response options may be applicable to a single clinic visit, please give prescedence to the symptomatic/new problem option. A response of null indicates that the information is collected but is unknown for this record.
20	F1_Pregnant	Does the female patient self-report being currently pregnant?
		1= Yes
		2= No
		3= Patient does not know/ not sure
		9= Not captured
		If information is collected but patient is not sure, then appropriate response is 3. A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values allowed for men or if information is collected by the facility but unknown for this record.
21	F1_Sympt	Did the patient present with symptoms consistent with a STI (includes genital pain, itching, dysuria, genital sores or rash, vaginal/penile/rectal discharge?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
22	F1_Contact_GC	Was the patient a contact to or exposed to gonorrhea?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
22.1	F1_Contact_CT	Was the patient a contact to or exposed to chlamydia?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
22.2	F1_contact_SY	Was the patient a contact to or exposed to syphilis?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
22.3	F1_contact_Other	Was the patient a contact or exposed to a STD (other than syphilis, chlamydia, or gonorrhea)?
		1= Yes, HSV
		2= Yes, MPX
		3. Yes, multiple
		4. Yes, don’t know specific STD
		5. No, not a contact or exposed to STD
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
23	F1_Pelvic_exam	Was a pelvic exam performed?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values allowed for men or if information is collected by the facility but unknown for this record.
24	F1_MENSEX	In the past 3 months, how many sex partners with male genitalia does the patient report?
		If number of male sex partners is unknown, missing, or not captured, use null value.
25	F1_FEMSEX	In the past 3 months, how many sex partners with female genitalia does the patient report?
		If number of female sex partners is unknown, missing, or not captured, use null value.
26	F1_TRANSEX	In the past 3 months, how many sex partners reported to be transgendered does the patient report?
		If number of female sex partners is unknown, missing, or not captured, use null value.
28	F1_SEXOR3	In the past 3 months, who does the patient report as sex partners?
		1= Partners with male genitalia only
		2= Partners with female genitalia only
		3= Both
		4= No Sex Partners Last 3 Mos
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
29	F1_SEXOR3TG	In the past 3 months, does the patient report having sex with a transgendered person (transgender man, transgender woman, or transgender unspecified)?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
30	F1_NUMSEX3	In the past 3 months, how many sexual partners does the patient report?
		If number of sex partners is unknown, missing, or not captured, use null value.
31	F1_SEXUALITY	How does the person characterize their sexual orientation?
		1= Gay/lesbian/homosexual
		2= Straight/heterosexual (not Gay or Lesbian)
		3= Bisexual
		4= Other
		9 = Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected by the facility but is unknown for this record.
32	F1_NewSex	In the last 3 months, does the patient report having a new sexual partner(s)?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
33	F1_Rectal_exposure	In the past 3 months, does the patient report receptive anal sex with a male sexual partner?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
34	F1_Oral_Sex	In the past 3 months, does the patient report oral receptive sex with a male sexual partner?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
35	F1_condom	In the past 3 months, does the patient report condomless sex (may include receptive anal or vaginal sex) with a male sexual partner?
		1= Yes
		2= No
		3= Patient not sure/ unknown /refused
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
36	F1_HIV_partner	In the past 12 months, does the patient report having sex with a person living with HIV/AIDS?
		1= Yes
		2= No
		3= Patient not sure/ unknown /refused
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
37	F1_IVDU	In the past 3 months, does the patient report use of illicit injected drugs?
		1= Yes
		2= No
		3= Patient not sure/ unknown /refused
		9= Not captured
		If information is collected by the facility but patient is not sure, then appropriate response is 3. A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
38	F1_OPIOID	In the past 3 months, does the patient report use of opioids (but not under a physician's orders)?
		1= Yes
		2= No
		3= Patient not sure/ unknown /refused
		9= Not captured
		If information is collected by the facility but patient is not sure, then appropriate response is 3. A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record or (2) that there was not an opportunity for a “no” response.
38.1	F1_Prep_Scrn	Was this patient counseled and screened for PrEP eligibility?
		1=Yes
		2=No, Patient HIV+
		3=No, Patient Refused
		4=No, Express Visit Only
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
38.2	F1_Prep_Elig	Was this patient eligible for PrEP?
		1=Yes
		2=No, Patient Not Eligible (HIV+)
		3=No, Patient Not Eligible (Other Reason)
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
38.3	F1_Prep_Ref	Was this patient referred for PrEP services?
		1=Yes, Referred to in-house PrEP specialist
		2=Yes, Referred to external PrEP provider
		3=No, Patient Not Eligible
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
38.4	F1_Prep_Rx	Was this patient prescribed PrEP at this visit?
		1=Yes, Initial PrEP prescription given
		2=Yes, Prescription refilled
		3=No, Patient not prescribed PrEP
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
39	F1_PrEP	Is the patient currently on PrEP?
		1= Yes
		2= No
		3= Patient not sure/ unknown /refused
		9= Not captured
		If information is collected by the facility but patient is not sure, then appropriate response is 3. A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected but is unknown for this record.
40	F1_PEP_rec	Was the patient dispensed/provided HIV PEP at this STD clinic visit?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected but is unknown for this record.
41	F1_PrEP_rec	Was the patient dispensed/provided PrEP at this STD clinic visit?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. A response of null indicates that the information is collected but is unknown for this record.
41.1	F1_dPEP_Rx	Was the patient prescribed doxycycline post-exposure prophylaxis at this visit?
		1=Yes
		2=No
		9=Not Captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
42	F1_Partner_tx	Was the patient prescribed or given medication for expedited partner therapy at this visit?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates that EPT is provided by the facility, but information is not captured or collected or is not provided to SSuN. A response of null indicates that the (1) information is collected by the facility but is unknown for this record, or (2) information is collected by the facility but there is not an opportunity for a “no” response.
42.1	F1_MPOX_VaxHx	Has this patient been previously vaccinated for smallpox or mpox?
		1=Yes, fully vaccinated
		2=Yes, not fully vaccinated
		3=No, no prior smallpox or mpox vaccination
		4=Refused to provide vaccination information
		9=Not captured
42.2	F1_MPOX_VaxDATE	If patient previously vaccinated for smallpox or mpox, date of most recent dose.
		MM/YY
		../..
42.3	F1_MPOX_Vax	Was this patient vaccinated for smallpox or mpox at this visit?
		1=Yes, Administered Initial Dose
		2=Yes, Administered Second Dose
		3=Yes, Administered >2nd dose
		4=No, no MPX vaccine administered
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed.
42.4	F1_MPOX_Vax_Spec	What smallpox or mpox vaccine was administered at this visit?
		1=JYNNEOS (Imvamune or Imvanex)
		2=ACAM2000
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed if F1_MPX_Vax= 1,2 or 3.
42.5	F1_MPOX_Vx_Mthd	What was the method of smallpox or mpox vaccine administration at this visit?
		1=Intradermal (ID)
		2=Subcutaneous (SQ)
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed if F1_MPX_Vax= 1,2 or 3.
42.6	F1_MPOX_Vx_Lot	What is the vaccine lot number of the vaccine administered at this visit?
		Text
		A response of 9999 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed if F1_MPX_Vax= 1,2 or 3.
42.7	F1_MPOX_Vx_dosage	What vaccine dose was administered at this visit?
		#####
		A response of 9999 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value not allowed if F1_MPX_Vax= 1,2 or 3.
42.8	F1_MPOX_Vx_dosUnit	What was the vaccine dose unit for the vaccine administered at this visit?
		1=mL
		2=CC
		3=mG
		4=μG (microgram)
		9=Not Captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN.  Null value not allowed if F1_MPX_Vax= 1,2 or 3
43	F1_SXRectal	Does the patient report rectal symptoms (e.g., discharge, pain, itching, bleeding)?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
44	F1_SXPharyngeal	Does the patient report oral symptoms (e.g., soreness, pain, blisters)?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response..
45	F1_SXAbdomen	Did the patient report abdominal pain?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
46	F1_SXDysuria	Did the patient report dysuria?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
47	F1_SXDischarge	Did the patient report a vaginal (abnormal), rectal or penile discharge?"
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
48	F1_SXLesion	Does the patient report an oral or genital ulcer/blister?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
48.1	F1_Sxitching	Did the patient report a vaginal (abnormal), rectal or penile (urethral) itching?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
48.2	F1_SXPain	Did the patient report a vaginal (abnormal), rectal or genital pain?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
48.3	F1_SXRash	Did the patient report a genital/anal rash?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
48.4	F1_Sxbleeding	Did the patient report a vaginal (abnormal), rectal or (urethral ) penile bleeding?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response.
49	F1_PEDischarge	Is there a finding of abnormal discharge on physical exam?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response, or 3(patient is a female).
50	F1_PEAbdomen	Is there a finding of lower abdominal pain/tenderness on physical exam?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but (1) is unknown for this record or (2) there is not an opportunity for a “no” response, or 3(patient is a female).
53	F1_HIVTest	Does the patient report ever tested for HIV? (excluding HIV testing on today’s visit)?
		1= Yes
		2= No
		3= Patient does not know/ not sure
		9= Not captured
		If information is collected by the facility but patient is not sure, then appropriate response is 3. A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values allowed if information is collected by the facility but unknown for this record.
54	F1_HIVTestdate	When was the patient's most recent test for HIV (month and year)? (excluding HIV testing on today’s visit)?
		Null values are allowed if (1) response to F1_HIVTest is either 2, 3, 9 or (2) patient does not know/ or not sure of the date of most recent HIV test.
55	F1_HIVResultlast	What was the result of the patient's most recent test for HIV (excluding HIV testing on today’s visit)?
		0 = Negative
		1 = Positive/preliminary positive
		2 = Indeterminant
		3= Patient does not know/ not sure
		9 = Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value are allowed if (1) response to F1_HIVTest is either 2, 3,9 or (2) patient does not know/ or not sure of the result of the most recent HIV test.
56	F1_HIVTest_refuse	Did the patient refuse an HIV test today?
		1= Yes
		2= No
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but is unknown for this record.
57	F1_HregMatch	Was eHARS registry match done for this patient?
		1=Yes
		2=No
		This data element may be initially coded as ‘2’ if the grantee conducts a batch match with their HIV registry and the case is reported before that batch is processed. This information can be updated in the SSuN record in the next data transmission following the match. This data element should not be ‘null’ or contain missing values.
58	F1_HIVcare	Is the patient currently in HIV care?
		1=Yes
		2=No
		3= Patient is not HIV positive
		4= Unknown
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but is unknown for this record.
59	F1_HregMatchStat	Did this patient match a registry entry in eHARS?
		1=Matching Record Found
		2=No Matching Record
		3=Match Not Performed
		This data element may be initially coded as ‘3’ if the grantee conducts a batch match with their HIV registry and the case is reported before that batch is processed. This information can be updated in the SSuN record in the next data transmission following the match. This data element should not be ‘null’ or contain missing values.
60	F1_HregID	Unique record number from HIV registry (such as stateno from eHARS).
		This data element should not be ‘null’ or contain missing values if a matching record is present in eHARS
61	F1_HDXMOYR	What is this patient's earliest indication of HIV positive result?
		This information can be obtained from the eHARS person table (HIVPMOYR) if eHARS match found (F1_HregMatchStat = 1).
62	F1_EXPMOD	Exposure mode from HIV registry.
		1=MSM Only
		2=IDU Only
		3=Heterosexual Contact Only
		4=MSM & IDU
		5=IDU & Heterosexual Contact
		6=MSM & Heterosexual Contact
		7=MSM, IDU & Heterosexual Contact
		8=Perinatal Exposure
		9=Other/Unknown
		This data element should not be ‘null’ or contain missing values if a matching record is present in eHARS (F1_HregMatchStat = 1).
63	F1_HPVVaxadmin	Was the patient given HPV vaccination at this visit?
		1= Yes
		2= No, not indicated/refused
		3= No, clinic does not administer/offer HPV vaccination
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but is unknown for this record.
63.1	F1_MPXadmin	Was the patient given MPX vaccination at this visit?
		1= Yes
		2= No, not indicated/refused
		3= No, clinic does not administer/offer MPX vaccination
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null values are allowed if the information is collected by the facility but is unknown for this record.
63.2	F1_GCtx	Was patient prescribed antimicrobials for gonorrhea treatment?
		1= Yes
		2= No, not indicated/refused
		9= Not captured
63.3	F1_CTtx	Was patient prescribed antimicrobials for chlamydia treatment?
		1= Yes
		2= No, not indicated/refused
		9= Not captured
	Data Element Name	Description/Response Coding
	Diagnosis Dataset
64	F2_PatientID	Unique patient identification number assigned by site
		Will be a secondary key for merging diagnosis and visit record data; should correspond to F1_PatientID. This patient ID should be supplied by the site and may be an person ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values.
65	F2_Eventid	Unique visit identification
		Will be a secondary key for merging diagnosis and visit record data; should correspond to F1_Eventid. This record ID should be supplied by the site and may be an event or visit ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values except if a treatment record exists independant of a visit.
66	F2_Visdate	Date of clinic visit
		Will be a secondary key for merging diagnosis and visit record data; should correspond to F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values except if a treatment record exists independent of a visit.
67	F2_DXCODE	Diagnosis Code
		SY01=Syphilis, primary
		SY02=Syphilis, secondary
		SY03=Syphilis, early latent
		SY04=Syphilis, late latent/Unknown
		SY05=Syphilis, neurosyphilis
		SY06=Syphilis, unspecified/other
		GC01=Gonorrhea
		CT01=Chlamydia
		GW01=Genital Warts
		HI01=HIV/AIDS
		BV01=Bacterial vaginosis (BV)
		TR01=Trichomoniasis
		GH01=Genital Herpes
		NU01=Nongonococcal Urethritis (NGU)
		MC01=Muco-purulent cervicitis (MPC)
		MG01=Mycoplasma genitalium
		PI01=Pelvic Inflammatory Disease (PID)
		EP01=Epididymitis
		CC01=Chancroid
		LV01=Lymphogranuloma venereum (LGV)
		GI01=Granuloma Inguinale
		CD01=Candidiasis
		SC01=Scabies
		PD01=Pediculosis
		MPX1=MPX(Suspected)
		MPX2=MPX(Probable)
		MPX3=MPX(Confirmed)
		CS01=Contact to STD
		PG01=Pregnancy
		NE01=Normal exam/diagnosis
		OT01=Other
		Null values allowed if information is collected by the facility but unknown for this record.
	Data Element Name	Description/Response Coding
	Laboratory Dataset
68	F3_PatientID	Unique patient identification number assigned by site
		Will be a secondary key for merging with laboratory and visit record data; should correspond to F1_PatientID. This patient ID should be supplied by the site and may be an person ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values.
69	F3_Eventid	Unique visit identification
		Will be a secondary key for merging laboratory and visit record data ; should correspond to F1_Eventid. This record ID should be supplied by the site and may be an event or visit ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values except in the cases of HIV eHARS lab match records (in which case the variable F3_SpecColdate will not be equal to F3_visdate).
69.1	F3_Source	Did lab record originate from eHARS match?
		Default to 0 for records NOT coming from the eHARS registry, 1 for lab data from eHARS
70	F3_Visdate	Date of clinic visit
		Will be a secondary key for merging laboratory and visit record data; should correspond to F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values except in the cases of HIV eHARS lab match records (in which case the variable F3_SpecColdate will not be equal to F3_visdate.
71	F3_SpecColdate	Date of specimen collection for this laboratory observation
		Date the laboratory specimen was collected. Specimen collection date in many cases will be the same as F3_visdate; however it can be different in the case of HIV eHARS lab records since they may be collected independant of the clinic visit. This data element MUST NOT be ‘null’ or contain missing values.
72	F3_Condtested	What condition was the patient tested for?
		1 = Syphilis
		2 = Gonorrhea
		3 = Chlamydia
		4 = Chancroid
		5 = Trichomoniasis
		6 = HIV/AIDS
		7 = Bacterial vaginosis
		8 = Herpes
		9= Mycoplasm genitalium
		20 = Pregnancy
		Although a null value is allowed, sites should make every attempt to make sure the value is not a null value. A record for a lab condition not included in the list above, should not be submitted.
73	F3_Anatsite	What anatomic site was tested?
		1 = Urethral
		2 = Vaginal/cervical
		3 = Urine
		4 = Rectal
		5 = Pharynx
		6 = Blood
		8 = Other
		9= Not captured
		Although a null value is allowed, sites should make every attempt to make sure the value is not a null value.
74	F3_Test_Type	What type of test was used? (Will be expanded, recoded)
		1=Culture
		2=NAAT
		3=Non-amplified nucleic acid test/DNA probe
		4=Gram Stain
		5=DFA
		6=Rapid HIV
		7=ELISA
		8=Western blot (deprecated code, see 27, 28 below)
		9=Pooled RNA
		10=RPR
		11=VDRL
		12=FTA
		13=TP-PA
		14=MHA
		15=Wet Mount/Clue Cell
		16=PH
		17=Other, not listed
		18=Unknown
		22=HIV-1 IA (EIA or Other)
		23=HIV-1/2 IA (EIA or Other)
		24=HIV-2 IA (EIA or Other)
		25=HIV-1/2 Ag/Ab (4th generation)
		26=HIV-1/2 Type-Differentiating Immunoassay (4th generation)
		27=HIV-1 Western Blot
		28=HIV-2 Western Blot
		29=HIV-1 IFA
		30=HIV-1 Culture
		31=HIV-2 Culture
		32=HIV-1 p24 Antigen
		33=HIV-1 RNA/DNA NAAT (Qualitative)
		34=HIV-2 RNA/DNA NAAT (Qualitative)
		35=HIV-1 RNA/DNA NAAT (Quantitative viral load)
		36=HIV-2 RNA/DNA NAAT (Quantitative viral load)
		37=CD4 T-lymphocytes
		38=CD4 Percent
		39=HIV-1 Genotype (PR Nucleotide Sequence)
		40=HIV-1 Genotype (RT Nucleotide Sequence)
		41=HIV-1 Genotype (PR/RT Nucleotide Sequence)
		42=HIV-1 Genotype (IN Nucleotide Sequence)
		43=HIV-1 Genotype (PR/RT/IN Nucleotide Sequence)
		44=STARHS (BED)
		45=STARHS (Vironostika-LS)
		46=STARHS ( BIO-RAD AVIDITY)
		47=STARHS (Other)
		48=STARHS (Unknown)
		49=Rapid (Retired)
		50=HIV-1/2 Ag/Ab-Distinguishing Immunoassay
		51=HIV-1 Genotype (EN Nucleotide Sequence)
		52=HIV-1 Genotype (FI Nucleotide Sequence)
		53=HIV-1/2 Ag/Ab and Type-Differentiating Immunoassay
		54=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 p24 Antigen Analyte
		55=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 Antibody Analyte
		56=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-2 Antibody Analyte
		57=HIV-1/2 Type-Differentiating Immunoassay (Supplemental)
		58=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-1 Antibody Analyte
		59=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-2 Antibody Analyte
		60=HIV-1 Genotype (Unspecified)
		61=WB/IFA-Legacy
		62=RIPA-Legacy
		63=Latex Ag-Legacy
		64=Peptide-Legacy
		65=Rapid-Legacy
		66=Iga-Legacy
		67=IVAP-Legacy
		68=Other HIV Antibody-Other-Legacy
		69=Other HIV Antibody-Unspecified-Legacy
		70=Viral Load-Other-Legacy
		71=Viral Load-Unspecified-Legacy
		72=HIV Detection/Antigen/Viral Load-Other-Legacy
		73=HIV Detection/Antigen/Viral Load-Unspecified-Legacy
		74=Syphilis EIA test
		75=T. Vaginalis Rapid Test
		76=T. Vaginalis NAAT
		80=Pregnancy
		81=T. Vaginalis Culture
		88= Other
		99=Not captured
		Although a null value is allowed, sites should make every attempt to make sure the value is not a null value.
75	F3_Qualres	What was the qualitative test result?
		0 = Negative
		1 = Positive
		2 = Nonreactive
		3 = Reactive
		4 = Indeterminate/equivocal
		5=Unknown/no result
		6 = QNS/Contaminated/Unsaturated
		8 = Other/pending
		9=Not captured
		10= Gram Stain Only: Gram-negative intracellular diplococci (GNID)
		11=Gram Stain Only: ≥2 WBCs / high power field without GNID
		12= Gram Stain Only: NGU with <2WBC and no GNID
		13= Gram Stain Only: negative results
		Although a null value is allowed, sites should make every attempt to make sure the value is not a null value.
76	F3_Quantres	Numeric - or Ratio (for RPR/VDRL, e.g. 1:2, 1:4, etc.)
77	F3_QuantUnits	Units for quantitative results:
		1=Copies/mL
		2=Log Copies/mL
		3=Cells/Cubic mm
		4=CD4%
		5=Titer Ratio
		6=Cycles/Time (rtPCR)
DE #	Data Element Name	Description/Response Coding
	Treatment Dataset
78	F4_PatientID	Unique patient identification number assigned by site
		Will be a secondary key for merging treatment and visit record data; should correspond to F1_PatientID. This patient ID should be supplied by the site and may be an person ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values.
79	F4_Eventid	Unique visit identification
		Will be a secondary key for merging treatment and visit record data; should correspond to F1_EventID. This record ID should be supplied by the site and may be an event or visit ID assigned at the clinic level. This data element MUST NOT be ‘null’ or contain missing values except in the case where treatment date (f4_TxDate) is different from F4_Visdate.
80	F4_Visdate	Date of clinic visit
		Will be a secondary key for merging treatment and visit record data; should not be ‘null’ or contain missing values except in the case where treatment date (f4_TxDate) is different from F4_Visdate.
81	F4_TxDate	Treatment Date
		Date the treatment was dispensed or prescribed. Treatment date in many cases will be the same as F4_visdate; however it can be different if treatment was provided independant of the clinic visit. This data element MUST NOT be ‘null’ or contain missing values.
82	F4_Medication	What medication was prescribed to the patient (brand name)?
		1=Penicillin G (benzathine, aqueous procaine, or aqueous crystalline)
		2=Probenacid
		10= Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
		11= Ampicillin (Omnipen, Polycillin, Polycillin-N, Principen, Totacillin)
		20= Azithromycin (Zithromax)
		21= Erythromycin base
		22= Clindamycin (Cleocin)
		23= Gentamicin (Garamycin, G-Mycin, Jenamicin)
		30= Cefixime (Suprax)
		31= Ceftizoxime (Cefizox)
		32= Cefotaxime (Claforan)
		33= Cefoxitin (Mefoxin)
		34= Cefpodoxime (Vantin)
		35= Ceftibuten (Cedax)
		36= Cefdinir (omnicef)
		37= Ceftriaxone (Rocephin)
		38= Cefuroxime (Ceftin, Kefurox, Zinacef, Zinnat)
		40= Ciprofloxacin (Cipro, Cipro XR, Ciprobay, Ciproxin)
		41= Levofloxacin (Cravit, Levaquin)
		42= Moxifloxacin (Avelox, Vigamox)
		43= Ofloxacin (Floxin, Oxaldin, Tarivid)
		44= Gemifloxacin (Factive)
		50= Doxycycline (Doryx, Vibramycin)
		60= Metronidazole (Flagyl, Helidac, Metizol, Metric 21, Neo-Metric, Noritate, Novonidazol)
		61= Tinidazole (Tindamax)
		70= Tenofovir/emtricitabine (Truvada, Descovy)
		71= Raltegravir (Isentress)
		72= Dolutegravir (Tivicay)
		73=Apretude (Cabotegravir)
		74= Hepatitis B vaccine
		75= Hepatitis A vaccine
		76= Doxy PEP
		88= Other
		99=Unknown
		Although a null value is allowed, sites should make every attempt to make sure the value is not a null value.
83	F4_Medication_Oth	If the patient received a medication other than what is listed above as
		indicated by response option #88, please provide name of other medication (Free text description of other medication)
83.1	F4_TxMethod	New Variable to capture method of administrtaion
		1=PO - oral dosing
		2=IM - intramuscular
		3=IV - intravenous/infusion
		4=Other
		5=Unknown
		6=Intravaginal
		7=Topical
84	F4_Dosage	What was the dosage of the medication prescribed?
		1= 100 mg
		2= 125mg
		3= 150mg
		4= 200mg
		5= 240mg
		6= 250mg
		7= 300mg
		8= 320mg
		9= 400mg
		10= 500mg
		11= 600mg
		12= 750mg
		13= 800mg
		14= 1g
		15= 2g
		16= 50 mg
		17=2.4 Million Units
		18=7.2 Million Units
		88= Other
		99= Not captured
		A response of 99 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value allowed if dosage is unknown or missing.
85	F4_Number_doses	Total number of doses prescribed?
		Null value allowed if (1) number of total doses is unknown or missing or (2) the information is not captured or collected by the facility or is not provided to SSuN. Sites can either collect number_doses or duration. It is NOT necessary to collect both variables. Refills should not be include in number of doses.
86	F4_Dose_Freq	What is the frequency of doses?
		1=one single dose
		2= twice day
		3= three times a day
		4= four times a day
		8= other
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value allowed if frequency of doses is unknown or missing.
87	F4_Duration	What duration was the medication prescribed for?
		1= 1 day
		2= 3 days
		3= 5 days
		4= 7 days
		5= 10 days
		6= 14 days
		8= Other
		9= Not captured
		A response of 9 indicates the information is not captured or collected by the facility or is not provided to SSuN. Null value allowed if duration of medication is unknown or missing.
DE #	Data Element Name	Description/Response Coding
	Facility Reference Dataset
88	F5_Facility_ID	Unique facility identifier
		This ID should be supplied by the site and is a unique facility identifier from underlying surveillance systems or may be generated specifically for SSuN. Regardless of source, this ID must be unique and allow for longitudinal tracking of the facility. This data element MUST NOT be ‘null’ or contain missing values.
89	F5_SiteID	Unique site code
		BA=Baltimore (Cycle II, Cycle III, Cycle IV)
		CB=Columbus Ohio (Cycle IV)
		CA=California (Cycle II, Cycle III, Cycle IV)
		FL=Florida (Cycle III & Cycle IV)
		IN=Indiana (Cycle IV)
		MC=Multnomah County (Cycle III &Cycle IV)
		NY=New York City (Cycle II, Cycle III, Cycle IV)
		PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
		SF=San Francisco (Cycle II, Cycle III, Cycle IV)
		WA=Washington (Cycle II, Cycle III, Cycle IV)
		UT=UTAH (Cycle IV)
		LA=Louisana (Cycle II)
		VA=Virginia (Cycle II)
		AL=Alabama (Cycle II)
		CO=Colorado (Cycle II)
		CH=Chicago (Cycle II)
		MA=Massachusetts (Cycle III)
		MN=Minnesota (Cycle III)
		This data element MUST NOT be ‘null’ or contain missing values.
90	F5_Facility_name	What is the name of the facility?
		This data element MUST NOT be ‘null’ or contain missing values.
91	F5_Facility_type	What is the facility type?
		1= STD clinic
		88= Other
92	F5_FQHC	Is this facility a FQHC?
		1= Yes
		2= No
93	F5_Facility_Address	What is the physical street address of the facility?
94	F5_Facility_City	In what city is the facility located?
		FIPS code, example: 3290 (City of SF)
95	F5_Facility_State	In what state is the facility located?
		FIPS code
96	F5_Facility_Zip	Zip code for the facility (9-digit ZIP code of facility)
97	F5_Point_contact	Point of contact at facility
98	F5_EPT	Does the facility have written policies governing expediated partner therapy?
		1= Yes
		2= No
		9= Facility does not provide/prescribe/test
99	F5_PrEP	Does the facility have written policies governing referral or management of PrEP?
		1= Yes
		2= No
		3= facility does not refer to or manage PrEP
100	F5_PrEP_Rx	Does the facility prescribe PrEP?
		1= Yes
		2= No
101	F5_PEP_Rx	Does the facility prescribe PEP?
		1= Yes
		2= No
102	F5_PrEP_Manage	Does the facility actively manage patients on PrEP?
		1= Yes
		2= No
103	F5_HPV_vaccine	Does the facility have written policies governing HPV vaccination?
		1= Yes
		2= No
		9= Facility does not provide/prescribe/test
104	F5_HIV_algorithm	Does the facility have written policies governing HIV testing?
		1= Yes
		2= No
		3= Facility does not provide/prescribe/test
105	F5_Screening_CT	Does the facility have written policies governing chlamydia screening?
		1= Yes
		2= No
		3= Facility does not provide/prescribe/test
106	F5_Screening_GC	Does the facility have written policies governing gonorrhea screening?
		1= Yes
		2= No
		3= Facility does not provide/prescribe/test
107	F5_Billing	Does the facility bill for STD services?
		1= Yes
		2 = No
		9= Not captured
108	F5_Medical_record	Type of medical record system?
		1= paper-based
		2= electronic
		3=combination
		9= not sure
109	F5_Insurance	Is the facility in an insurance network?
		1=Yes
		2=No
Clinic Patient Survey
110	FS1_FirstVis	First visit at clinic?
		1=Yes
		2=No
111	FS1_Welcome	Do you feel that this clinic provides a welcoming and respectful environment?
		1=Yes
		2=No
		3=Not Sure
		What are the reasons for your visit to this clinic today (choose all that apply)?
		Code Below
112	FS1_Reas1	Health problem or symptoms
		1=Yes
		2=No
113	FS1_Reas2	No health problems or symptoms, but came to get STD screening/check-up
		1=Yes
		2=No
114	FS1_Reas3	Told to get checked by partner
		1=Yes
		2=No
115	FS1_Reas4	Referred by health department/disease intervention specialist (DIS)
		1=Yes
		2=No
116	FS1_Reas5	Follow-up visit
		1=Yes
		2=No
117	FS1_Reas6	Came to get STD test results
		1=Yes
		2=No
118	FS1_Reas7	Came to get HIV test
		1=Yes
		2=No
119	FS1_Reas8	Came to get medication that I can take every day to prevent getting HIV infection before I am exposed to the virus (PrEP)
		1=Yes
		2=No
120	FS1_Reas9	Came to get medication that I can take right away because I think I was exposed to HIV in the past few days (PEP)
		1=Yes
		2=No
121	FS1_Reas10	Came to get contraception
		1=Yes
		2=No
122	FS1_Reas11	Some other reason
		1=Yes
		2=No
123	FS1_Reas12_TXT	Specify ____________________
124	FS1_ReasThisClin	What is the main reason you chose this clinic for care (choose only one)?
		1=Could walk in or get same day appointment
		2=Cost
		3=Privacy concern
		4=Expert care
		5=Embarrassed to go to usual doctor
		6=Some other reason
125	FS1_ReasThisClin_TXT	Please specify other reason ______________________
126	FS1_WhereElse	Where would you have gone today if this STD clinic did not exist (choose only one)?
		1=I would have waited to see how I felt and then decided what to do
		2=Community health center
		3=Public clinic/ health department clinic
		4=Family planning clinic
		5=Private doctor’s office
		6=Urgent care clinic/walk in clinic
		7=Hospital emergency room (ER)
		8=Hospital outpatient department
		9=School-based clinic
		10=Some other place
127	FS1_WhereElse_TXT	Please specify other place ______________________
128	FS1_UsualPlace	Is there a place that you USUALLY go to when you are sick or need advice about your health?
		1=Yes
		2=No
129	FS1_MostOftenGo	If YES, what kind of place do you go to most often (choose only one)?
		1=Community health center
		2=Public clinic/health department clinic
		3=Family planning clinic
		4=Private doctor’s office
		5=Urgent care clinic/walk in clinic
		6=Hospital emergency room (ER)
		7=Hospital outpatient department
		8=School-based clinic
		9=Some other place
130	FS1_MostOftenGo_TXT	Please specify ________________________
131	FS1_PrevCare	Is there a place you USUALLY go to when you need routine care or preventive care such as a physical exam or check-up?
		1=Yes
		2=No
132	FS1_PrevCareGo	If YES, what kind of place do you go to most often (choose only one)
		1=Community health center
		2=Public clinic/health department clinic
		3=Family planning clinic
		4=Private doctor’s office
		5=Urgent care clinic/walk in clinic
		6=Hospital emergency room (ER)
		7=Hospital outpatient department
		8=School-based clinic
		9=Some other place
133	FS1_PrevCareGo_TXT	Please specify ________________________
134	FS1_Insurance	Do you have health insurance (choose only one)?
		1=Yes, parents’ insurance plan
		2=Yes, government (Medicaid, Medicare, etc.)
		3=Yes, private insurance (through employer)
		4=Yes, private insurance (purchased by yourself/healthcare.gov exchange)
		5=No coverage of any type à GO TO QUESTION # 13
		6=Don’t know à GO TO QUESTION # 13
135	FS1_UseIns	If YES, would you be willing to use your health insurance for today’s visit?
		1=Yes
		2=No
		If No, why not (choose all that apply)?
136	FS1_NOTUseIns1	I do not want my insurance company to know
		1=Yes
		2=No
137	FS1_NOTUseIns2	Insurance company might send records home
		1=Yes
		2=No
138	FS1_NOTUseIns3	I do not want my parents/spouse/significant other to know
		1=Yes
		2=No
139	FS1_NOTUseIns4	Usual doctor might send records home
140	FS1_NOTUseIns5	I cannot afford to pay the co-pay or deductible
141	FS1_NOTUseIns6	My insurance will not cover this visit
142	FS1_NOTUseIns7	Some other reason
143	FS1_NOTUseIns_TXT	Please specify
144	FS1_BirthSex	What sex were you assigned at birth on your original birth certificate?
		1=Male
		2=Female
		3=Refused
		4=Don't know
145	FS1_GendID	How do you currently describe yourself?
		1=Male
		2=Female
		3=Trans, Male to Female
		4=Trans, Female to Male
		5=TG Unknown or Unspecified
		6=Gender Queer/Non-Binary
		7=Other
146	FS1_Age	How old are you? Age in years______
147	FS1_HispEth	Do you consider yourseld Hispanic/Latino/a?
		1=Yes, Hispanic
		2=No, Not Hispanic
		8=Unknown/Can't guess
		9=Refused
		What is your race (choose all that apply)?
148	FS1_RaceWhite	White
		1=Yes
		2=No
149	FS1_RaceBlack	Black
		1=Yes
		2=No
150	FS1_RaceAIAN	AI/AN
		1=Yes
		2=No
151	FS1_RaceAsian	ASIAN
		1=Yes
		2=No
152	FS1_RaceNHOPI	NH/OPI
		1=Yes
		2=No
153	FS1_RaceOther	Other race
		1=Yes
		2=No
154	FS1_RaceUnk	Unknown/Can't guess
		1=Yes
		2=No
155	FS1_RaceRef	Refused Race
		1=Yes
		2=No
156	FS1_SexOrient	Which of the following best represents how you think of yourself?
		1=Heterosexual/Straight
		2=Gay/Lesbian/Homosexual
		3=Bisexual
		4=Other
		5=I don't know
		9=Refused
		What is your current employment status (choose all that apply)?
157	FS1_Employ1	Full-time employment
		1=Yes
		2=No
158	FS1_Employ2	Part-time employment
		1=Yes
		2=No
159	FS1_Employ3	Unemployed
		1=Yes
		2=No
160	FS1_Employ4	Disabled
		1=Yes
		2=No
161	FS1_Employ5	Student
		1=Yes
		2=No
162	FS1_Employ6	Other
		1=Yes
		2=No
163	FS1_Educate	What is your highest level of school you have completed or the highest degree you have received
		1=Middle school
		2=Some high school
		3=High school diploma
		4=GED or equivalent
		5=Some college
		6=College degree or higher
Strategy B - Case-based Enhanced Surveillance
	Data Element Name	Description
164	P1_SiteID
		This 2 character code primarily identifies sites funded under SSuN Cycle 2 & 3 and will include additional sites as required for Cycle 4. This data element MUST NOT be ‘null’ or contain missing values.
		BA=Baltimore (Cycle II, Cycle III, Cycle IV)
		CB=Columbus (Cycle IV)
		CA=California (Cycle II, Cycle III, Cycle IV)
		FL=Florida (Cycle III & Cycle IV)
		IN=Indiana (Cycle IV)
		MC=Multnomah County (Cycle III &Cycle IV)
		NY=New York City (Cycle II, Cycle III, Cycle IV)
		PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
		SF=San Francisco (Cycle II, Cycle III, Cycle IV)
		WA= Washington (Cycle II, Cycle III, Cycle IV)
		UT=UTAH (Cycle IV)
		LA=Louisana (Cycle II)
		VA=Virginia (Cycle II)
		AL=Alabama (Cycle II)
		CO=Colorado (Cycle II)
		CH=Chicago (Cycle II)
		MA=Massachusetts (Cycle III)
		MN=Minnesota (Cycle III)
165	P1_EventID	Site generated unique event identifier
		This record ID should be supplied by the site and may be an event or report identifier from underlying surveillance system. Regardless of source, this ID must be unique for each confirmed case report. This data element MUST NOT be ‘null’ or contain missing values.
166	P1_PatientID	Site generated ID allows for longitudinal tracking of unique persons
		This ID should be supplied by the site and may be a unique patient identifier from underlying surveillance systems or may be generated specifically for SSuN from identifying information provided through case reporting. Regardless of source, this ID must be unique and allow for longitudinal tracking of persons reported with multiple episodes of disease. This data element MUST NOT be ‘null’ or contain missing values.
167	P1_RecRepDte	Earliest date this specific disease event/report received at health department?
		This date should reflect the earliest information available to the health department regarding the case. This date should include laboratory records received if lab results were reported prior to receipt of a provider case report. This data element MUST NOT be ‘null’ or contain missing values. This should be coded as a ‘SAS’ numeric date.
168	P1_DxDte	What is the diagnosis date for the current episode of disease (may be date of provider visit, specimen collection date, laboratory report date or other suitable proxy)
		This data element should not be ‘null’ or contain missing values. This should be coded as a ‘SAS’ numeric date.
169	P1_DxCode	Diagnosis
		This data element should not be ‘null’ or contain missing values. For this cycle of SSuN, only values for gonorrhea and for syphilis (10280 and 10311, 10312, 10313 and 10320 are acceptable)
		10273=Chancroid
		10274=Chlamydia
		10280=Gonorrhea
		10311=Syphilis, primary
		10312=Syphilis, secondary
		10313=Syphilis, early non-primary non-secondary
		10320=Syphilis, unknown duration or late
170	P1_RandSamp	Is this record/case selected in the random sample?
		This data element MUST NOT be ‘null’ or contain missing values. (Note: both gonorrhea and syphilis records should be sampled)
		0=Not in random sample
		1=In random sample
171	P1_SampDte	Date record/case sampled by jurisdiction
		For jurisdiction deploying a batch process for record sampling, this should be the actual date that the batch was sampled. For jurisdictions deploying real-time sampling of cases through their surveillance system, this date should match the report date (or date case status was confirmed if appropriate). This data element should not be ‘null’ or contain missing values. This should be coded as a ‘SAS’ numeric date.
174	P1_InitSx	If patient previously reported, what is the registry/source of earliest report for this PATIENT? (If the patient was not known to have been previously reported for any disease/condition, this data element may be coded as '.'/Null)
		0=STD Registry
		1=HIV Registry
		2=Viral Hepatitis Registry
		3=Other Disease Registry
		4=Unknown
175	P1_HregMatch	Was eHARS registry match done for this patient?
		This data element may be initially coded as ‘2’ if the grantee conducts a periodic batch match with their HIV registry and the case is reported before that batch is processed. This information can be updated in the SSuN record in the next data transmission following the match. This data element should not be ‘null’ or contain missing values.
		1=Yes
		2=No
176	P1_HregMatchStat	Did this patient match a registry entry in eHARS?
		This data element may be initially coded as ‘3’ if the grantee conducts a periodic batch match with their HIV registry and the case is reported before that batch is processed. This information can be updated in the SSuN record in the next data transmission following the match. This data element should not be ‘null’ or contain missing values.
		1=Matching Record Found
		2=No Matching Record
		3=Match Not Performed
177	P1_HregID	Unique record number from HIV registry (such as stateno from eHARS).
		This data element should not be ‘null’ or contain missing values if a matching record is present in eHARS. Sites may decide to use a locally generated UNIQUE registry number rather than STATENO as long as this number can be used to obtain matching HIV laboratory data)
178	P1_HDXMOYR	What is this patient's earliest indication of HIV positive result?
		This information can be obtained from the eHARS person table (HIVPMOYR). If eHARS match found. This should be coded as character data (“MM/YY”) with missing information as “../..” or “../YY”
179	P1_EXPMOD	Exposure (HIV transmission) mode from HIV registry.
		This data element should not be ‘null’ or contain missing values if a matching record is present in eHARS.
		1=MSM Only
		2=IDU Only
		3=Heterosexual Contact Only
		4=MSM & IDU
		5=IDU & Heterosexual Contact
		6=MSM & Heterosexual Contact
		7=MSM, IDU & Heterosexual Contact
		8=Perinatal Exposure
		9=Other/Unknown
182	P1_PrevDx	Most recent previous diagnosis (if applicable; could include hep, TB or HIV)
		If this patient also has a record in other/ancillary disease registries as indicated above, indicate the diagnosis documented by that record. Should be ‘Null’ if no previous diagnosis is confirmed. Note that previous gonorrhea diagnoses are captured in DE#184, prioritize non-gonorrhea diagnoses for this data element (HIV, syphilis, CT, etc.)
		10311=Syphilis, primary
		10312=Syphilis, secondary
		10313=Syphilis, early non-primary non-secondary
		10320=Syphilis, unknown duration or late
		10280=Gonorrhea
		10274=Chlamydia
		10100=Hepatitis B, acute
		10105=Hepatitis B, chronic
		20001=Hepatitis C
		10562=HIV infection (non-AIDS)
		10560=AIDS
		10307=Nongonococcal Urethritis (NGU)
		10308=Muco-purulent cervicitis (MPC)
		10309=Pelvic Inflammatory Disease (PID)
		10273=Chancroid
		10306=Lymphogranuloma venereum (LGV)
		10276=Granuloma Inguinale
		20002=TB
		20003=Other
183	P1_PrevDxDte	Date of most recent previous diagnosis documented above.
		Should not be null if P1_PrevDx is not null.
184	P1_PrevGCDx	Has the patient been previously diagnosed and reported with GC?
		1=Yes
		2=No
		3=Registry records not searched
185	P1_PrevGCDxDte	Date of most recent previous diagnosis of GC documented above.
		Should not be null if P1_PrevGCDx = 1. This should be coded as a ‘SAS’ numeric date.
186	P1_ConcurCTDx	Was this patient diagnosed with CT at the same time as their current GC diagnoses?
		1=Yes, tested and found to be CT positive
		2=No, tested and found to be CT negative
		3=No, patient not tested for CT/No CT information available
187	P1_CaseDup	Is this record/case a duplicate report, new report or was duplicate status not determined?
		The grantee should document if an initial case report was subsequently found to be a duplicate of an existing case – the record should be retained in the SSuN dataset and coded as a duplicate (‘1’)? If the jurisdiction receives a report that they know to be a duplicate (same patient/eent in last 28 days) at the time of report, the record can be omitted from the SSuN datasets and not sampled for enhanced investigation. This data element should not be ‘null’ or contain missing values.
		0=New Case
		1=Duplicate Case (previously reported in last 28 days)
		9=Unknown, site surveillance system does not capture
188	P1_FacilityID	Site generated facility ID. Each reporting provider/facility must have a unique ID.
		This is a primary key for linking the provider type and other provider information to the case record. Historically, the majority of cases in any grantee’s jurisdictions will be reported from known providers, but for cases reported from entirely new or unknown providers, this field should be populated with that facility’s new number and be included in the next update of the provider reference file. This data element should not be ‘null’ or contain missing values.
191	P1_PtxSex	Current sex of the patient as indicated on initial health department report?
		This data element should not be ‘null’ or contain missing values. For transgender individuals, please record the gender direction (e.g. 'male' for a female to male trensgendered patient, if transgender but sex unknown, code as 9: "Unknown")
		1=Male
		2=Female
		9=Unknown
192	P1_PtxGendID	Gender Identity of the patient as indicated on initial health department report.
		This data element should not be ‘null’ or contain missing values. If this information is not reported on case or lab report, code as 9: "Gender Identity not documented"
		1=Male-to-Female Transgender
		2=Female-to-Male Transgender
		3=Transgender, not specified
		4=CIS Gender (Male or Female, NOT transgendered)
		9=Gender Identity not documented
193	P1_PtxRace_White	White Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
194	P1_PtxRace_Black	Black Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
195	P1_PtxRace_AIAN	American Indian/Alaska Native Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
196	P1_PtxRace_Asian	Asian Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
197	P1_PtxRace_NHOPI	Native Hawaiian/Other Pacific Islander Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
198	P1_PtxRace_Other	Other Race
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Yes
		2=No
		3=Unknown
		4=Refused
199	P1_PtxRace_UNK	Is all information on race and Hispanic ethnicity missing from initial
		If additional/supplemental information is received on race and ethnicity of patient but this information was missing from the initial report to the health department, please leave this data element coded as ‘1’ and capture the source of supplemental information below.
		1=Yes
		2=No
200	P1_PtxRaceSource	What is the source of the final race information of record as ascertained for this patient?
		For grantees able to distinguish the source of information for race, please indicate as appropriate. For grantees NOT able to distinguish the source of race data at all, code as ‘6’. If race information is missing/unknown from all sources, code as ‘5’.
		1=Patient Self-Report
		2=Provider Case Report
		3=Laboratory Report
		4=Previous Registry Record
		5=No Information Available from Any Source
		6=Source not Identifiable
201	P1_PtxHisp	Patient Hispanic ethnicity
		Information from case/lab reports to the health department only. Patient self-report from interviews should be captured in interview variables. If additional information from any source (other than patient report) is received, these data may be updated as required by underlying surveillance system.
		1=Hispanic
		2=Non-Hispanic
		3=Unknown
		4=Refused
202	P1_PtxHISPSource	What is the source of the final Hispanic ethnicity information
		For grantees able to distinguish the source of information for Hispanic ethnicity, please indicate as appropriate. For grantees NOT able to distinguish the source of Hispanic ethnicity data at all, code as ‘6’. If information is missing/unknown from all sources, code as ‘5’.
		1=Patient Self-Report
		2=Provider Case Report
		3=Laboratory Report
		4=Previous Registry Record
		5=No Information Available from Any Source
		6=Source not Identifiable
203	P1_PtxAGE	Age of patient from initial reporting record/document .
		If age information is missing/unknown from all sources, use null value.
204	P1_PtxAgeUnit	Age unit
		If #32 is null, use null value for this data element (‘.’)
		1=Years
		2=Months
205	P1_PtxCountyres	County of patient residence
		If information is missing/unknown, code to null value ( ‘.’)
206	P1_PtxCTract	Census Tract of patient residence
		If information is missing/unknown, code to null value (‘.’)
207	P1_PtxAddrStat	Was patient street address present and complete in initial reporting documents?
		This data element should not be ‘null’ or contain missing values.
		1=Street Address Known
		2=Street Address Missing
		3=Street Address Incomplete
208	P1_GCAccuracy	What is the basis of census tract assignment (XY coordinates, street segment, centroid, etc.)
		This data element should not be ‘null’ or contain missing values.
		1=Close (based on direct street segment, parcel, or lon/lat match.)
		2=Approximate (modification of address required to match to to street segment)
		3=Very approximate (based only on zip or city centroid)
		4=Not-geocodable (insufficient data to geocode, PO Box, General Delivery)
		9=Missing (no address available)
209	P1_SiteUrine	Urine 'site' of infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
210	P1_SiteVagCerv	Vaginal or cervical site of infection in women
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
211	P1_SiteUreth	Urethral site of infection - only if this is specifically indicated.
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
212	P1_SiteRect	Rectal site of infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
213	P1_SitePhar	Pharyngeal site of infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
214	P1_SiteEye	Ocular site of infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
215	P1_SiteSera	Blood or sera infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
216	P1_SiteJoint	Joint or synovial fluid infection
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
217	P1_SiteOTH	Site of infection, not specified above
		If information is missing/unknown, code as ‘3’
		1=Yes
		2=No
		3=Unknown
218	P1_SiteUNK	All site of infection information missing for this case - use only if no other information is available.
		If the answer to any one of 40-48 above is ‘1’ or ‘2’ then this data element should be coded ‘2’. If all data elements 40-48 are coded as ‘3’ then code this data element as ‘1’.
		1=Yes
		2=No
	Data elements from provider investigations
219	P2_ProvID
		This data element MUST NOT be ‘null’ or contain missing values for cases in the random sample. SHOULD NOT be null for all other cases (collaborators requested to include this information for all gonorrhea case records – this can be accomplished with a default coding of P2_ProvID= P1_FacilityID.
220	P2_ProvCO	County FIPS code for provider/facility physical location
		This should be coded as the 3-digit FIPS code for the county.
221	P2_ProvZIP	Facility/provider physical location 5-digit ZIP
222	P2_ProvCHC	Is facility/provider a Community Health Center (CHC)?
		Community Health Centers are not-for-profit primary care organizations governed by a community board and whose primary mission is to provide medical services to traditionally under-served populations. The primary way of determining CHC status is by self-identification (though some put it in their name). The National Association of Community Health Centers (NACHC) does maintain member lists as well. Non-profit and community board governance are the key features.
		1=Yes
		2=No
		3=Unknown
223	P2_ProvFQHC	Is facility/provider a Federally Qualified Health Center (FQHC)?
		Federally qualified health centers (FQHCs) include all organizations receiving grants under Section 330 of the Public Health Service Act (PHS). These are a matter of public record and lists are available from HRSA
		1=Yes
		2=No
		3=Unknown
224	P2_ProvPTXvisitDte	Date of patient initial visit for this issue, can be supplied/filled in from initial case report.
		This should be formatted as a ‘SAS’ numeric date.
225	P2_ProvClinType	What was the category of provider examining/treating this patient?
		1=MD
		2=RN
		3=PA
		4=ARNP
		5=LPN
		6=Other
		7=Unknown/Not Ascertained
226	P2_ProvPTX_GenderSP	Provider documented gender of sex partners
		1=Males only
		2=Females only
		3=Both Males and Females
		4=No Sex Partners Last 3 Mos
		9=Not Captured/Not Documented
227	P2_ProvPTX_Insure	Insurance status of patient from provider's records
		1=Yes, Insured
		2=No, Not Insured
		3=Unknown
228	P2_Urethritis	Was urethritis found on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
229	P2_Proctitis	Was proctitis found on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
230	P2_Epididymitis	Was epididymitis found on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
231	P2_PID	Was PID diagnosed.
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
232	P2_Discharge	Was discharge found on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
233	P2_OtherFinding	Were there other STD-related findings on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
234	P2_NoFinding	Were there NO findings on exam
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
235	P2_ProvScrnUreth	Was patient screened/tested for infection at urethral site
		1=Yes
		2=No
		3=Unknown
		4=Refused
236	P2_ProvScrnVagCerv	Was patient screened/tested for infection at vaginal/cervical site
		1=Yes
		2=No
		3=Unknown
		4=Refused
237	P2_ProvScrnAnal	Was patient screened/tested for infection at anorectal site
		1=Yes
		2=No
		3=Unknown
		4=Refused
238	P2_ProvScrnPhar	Was patient screened/tested for infection at pharyngeal site
		1=Yes
		2=No
		3=Unknown
		4=Refused
239	P2_ProvScrnHIV	Was patient screened/tested for HIV infection at time of visit
		1=Yes
		2=No
		3=Unknown
		4=Refused
	Treatment Repeating Table (sourced either from initial case report or provider investigations)
240	P2_PR_EventID	Primary key for merging treatment records with case file, should be the same as P1_EventID
		Must not be missing or null.
241	P2_PR_ProvPTX_TxDte	Treatment date (or date of administration, date prescription given)
		This should be coded as a ‘SAS’ numeric date. Missing/unknown information code as null (‘.’).
242	P2_PR_DrugName	What drug was patient treated with?
		01=Penicillin G (benzathine, aqueous procaine, or aqueous crystalline)
		02=Probenacid
		10= Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
		11= Ampicillin (Omnipen, Polycillin, Polycillin-N, Principen, Totacillin)
		20= Azithromycin (Zithromax)
		21= Erythromycin base
		22= Clindamycin (Cleocin)
		23= Gentamicin (Garamycin, G-Mycin, Jenamicin)
		30= Cefixime (Suprax)
		31= Ceftizoxime (Cefizox)
		32= Cefotaxime (Claforan)
		33= Cefoxitin (Mefoxin)
		34= Cefpodoxime (Vantin)
		35= Ceftibuten (Cedax)
		36= Cefdinir (omnicef)
		37= Ceftriaxone (Rocephin)
		38= Cefuroxime (Ceftin, Kefurox, Zinacef, Zinnat)
		40= Ciprofloxacin (Cipro, Cipro XR, Ciprobay, Ciproxin)
		41= Levofloxacin (Cravit, Levaquin)
		42= Moxifloxacin (Avelox, Vigamox)
		43= Ofloxacin (Floxin, Oxaldin, Tarivid)
		44= Gemifloxacin (Factive)
		50= Doxycycline (Doryx, Vibramycin)
		60= Metronidazole (Flagyl, Helidac, Metizol, Metric 21, Neo-Metric, Noritate, Novonidazol)
		61= Tinidazole (Tindamax)
		70= Truvada (Tenofovir/emtricitabine)
		71=Raltegravir (Isentress)
		72=Dolutegravir (Tivicay)
		88= Other (provide text in P2_PR_OthMedTXT)
		99=Not Captured
		Must not be missing or null.
243	P2_PR_OthMedTXT	Other medication if value of 88 selected for P2_PR_DrugName
244	P2_PR_Dosage	Dosage - numeric
		Missing/unknown information code as null (‘.’).
245	P2_PR_Dose_Units	Dosage units
		01-Miligrams (mg)
		02-Grams (g)
		03-Units
		04-Units/Kilogram
		05-Million Units
		06-Million Units/Kilogram
		07-Milliliters (ml)
246	P2_PR_Method	Method of administration
		01=PO - oral dosing
		02=IM - intramuscular
		03=IV - intravenous/infusion
		04=Other
		05=Unknown
		Missing/unknown information code as null (‘.’).
247	P2_PR_Number	Number of doses/day
		0=Single dose, STAT
		Numeric value for all other
		Missing/unknown information code as null (‘.’).
248	P2_PR_Duration_Number	Days duration or frequency of doses
		Missing/unknown information code as null (‘.’).
	Data elements from provider investigations
249	P2_ProvPTX_PDPT
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
250	P2_ProvPTX_HIBC	Was patient counseled to prevent transmission/reinfection?
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
250.1	P2_ProvPTX_PrepRx	Was patient prescribed PrEP?
		1=Yes
		2=No
		Missing/unknown information code as null (‘.’).
250.2	P2_ProvPTX_dPEPRx	Was patient prescribed doxycycline as STI prophylaxis?
		1=Yes
		2=No
		Missing/unknown information code as null (‘.’).
251	P2_ProvPTX_Refer	Was patient referred to HD (or other) for partner services?
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
252	P2_ProvPTX_PrepRefer	Was patient referred for PrEP?
		Missing/unknown information code as null (‘.’).
		1=Yes
		2=No
	Data elements from Patient Interviews
253	P3_IDX_ID	Interviewer/Investigator ID
		This is a locally assigned ID to uniquely identify the person conducting patient interview. This data element should not be ‘null’ or contain missing values for interviewed cases.
254	P3_PatientID	Unique identifier for person/patient
		Will be a secondary key for merging data; should correspond to P1_PatientID. This data element should not be ‘null’ or contain missing values for interviewed cases.
255	P3_EventID	Unique identifier for record
		Will be a primary key for merging data; should correspond to P1_EventID. This data element should not be ‘null’ or contain missing values for interviewed cases.
256	P3_IDX_CADate1	Contact attempt date 1
		This data element should not be ‘null’ or contain missing values for interviewed cases.
257	P3_IDX_CAout1	Contact attempt outcome 1
		This data element should not be ‘null’ or contain missing values for interviewed cases.
		0=Answer/Partial or Complete Interview Obtained
		1=No Answer/No Message
		2=No Answer/Message Left
		3=Answer/Hang up
		4=Answer/Refusal
		5=Answer/Reschedule DIS call-back
		6=Answer/Reschedule Patient Callback
		7=Number out of service
		8=Other
258	P3_IDX_CADate2	Contact attempt date 2
		This should be coded as a ‘SAS’ numeric date.
259	P3_IDX_CAout2	Contact attempt outcome 2
		0=Answer/Partial or Complete Interview Obtained
		1=No Answer/No Message
		2=No Answer/Message Left
		3=Answer/Hang up
		4=Answer/Refusal
		5=Answer/Reschedule DIS call-back
		6=Answer/Reschedule Patient Callback
		7=Number out of service
		8=Other
260	P3_IDX_CADate3	Contact attempt date 3
		This should be coded as a ‘SAS’ numeric date.
261	P3_IDX_CAout3	Contact attempt outcome 3
		0=Answer/Partial or Complete Interview Obtained
		1=No Answer/No Message
		2=No Answer/Message Left
		3=Answer/Hang up
		4=Answer/Refusal
		5=Answer/Reschedule DIS call-back
		6=Answer/Reschedule Patient Callback
		7=Number out of service
		8=Other
262	P3_IDX_CADate4	Contact attempt date 4
		This should be coded as a ‘SAS’ numeric date.
263	P3_IDX_CAout4	Contact attempt outcome 4
		0=Answer/Partial or Complete Interview Obtained
		1=No Answer/No Message
		2=No Answer/Message Left
		3=Answer/Hang up
		4=Answer/Refusal
		5=Answer/Reschedule DIS call-back
		6=Answer/Reschedule Patient Callback
		7=Number out of service
		8=Other
264	P3_IDX_Ixdate	Interview/Disposition Date
		This should be coded as a ‘SAS’ numeric date.
265	P3_IDX_Dispo	Patient Investigation/Interview Disposition
		Should not be ‘null’ for cases included in random sample.
		00=Investigation complete: patient contacted, interview completed
		01=Investigation complete: patient contacted, partial interview completed
		10=Investigation not complete: Phase 3 investigation pending
		11=Investigation not complete: patient contacted, refused interview
		12=Investigation not complete: patient contacted, unable to complete because of language barrier
		22=Investigation not complete: patient did not respond to contact attempts
		33=Investigation not complete: patient contact not initiated because patient resident in correctional, mental health or substance abuse facility
		44=Investigation not complete: patient contact not initiated because patient is active military on foreign deployment
		55=Investigation not complete: >60 days from diagnosis
		66=Investigation not complete: case determined to be OOJ
		77=Investigation not complete: insufficient contact information
		88=Investigation not complete: provider refused patient contact
		99=Investigation not complete: administrative closure/other reason
266	P3_PTX_age	What is your age?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		888=Refused
267	P3_PTX_Birthsex	What was your sex at birth (recorded on your birth certificate)?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1= Male
		2=Female
		3=Intersex
		4=Unknown
		9=Refused
267.1	P3_PTX_GendID	What gender or sex do you consider yourself to be?
		1=Male
		2=Female
		3=Male-to-Female TG
		4=Female-to-Male TG
		5=TG Unspecified
		6=Queer, Gender Non-binary
		7=Other
		8=Refused
268	P3_PTX_HispEthnic	Do you consider yourself to be Hispanic or Latino/a?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
271	P3_PTX_White	patient reported White race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
272	P3_PTX_Black	patient reported Black race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
273	P3_PTX_AIAN	patient reported AIAN race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
274	P3_PTX_AIAN_TXT	Tribal Affiliation
275	P3_PTX_Asian	patient reported Asian race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
277	P3_PTX_NHOPI	patient reported NHOPI race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
279	P3_PTX_OTHrace	patient reported other race
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Unknown
		4=Refused
280	P3_PTX_OTHraceTxt	Patient-reported other race
281	P3_PTX_RefRace	patient refuses provision of all race information
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
285	P3_PTX_Insure	Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, Indian Health Services, the V.A. or Military?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
286	P3_PTX_InsType	What kind of healthcare insurance do you have?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Private healthcare insurance provided by my employer
		2=Private healthcare insurance I pay for myself
		3=Public healthcare insurance like Medicaid, Medicare, or a "state-specific health plan"
		4=Active or retired military or dependent plan like the V.A. or
		5=Bureau of Indian Affairs/IHS/Urban Indian Health
		7=Other
		8=Don‘t know / Not sure
		9=Refused
287	P3_PTX_OthInsSpecify	Other type of insurance (text)
288	P3_PTX_PriCareDoc	Do you have one person you think of as your personal doctor or health care provider?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes, only one
		2=More than one or facility
		3=No
		4=Don't Know /Not Sure
		5=Refused
289	P3_PTX_Hccost	Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
290	P3_PTX_OOPE	When you went to see _______________ (mention provider, clinic or facility name) when you were diagnosed with gonorrhea, did you need to pay anything out-of-pocket at the time of your visit?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
291	P3_PTX_SYMP1	Before you went to see _______________ (mention provider, clinic or facility name) when you were diagnosed with gonorrhea, did you have any unusual discharge or oozing from your (penis/vagina)?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
292	P3_PTX_SYMP2	Before you went to see _______________ (mention provider, clinic or facility name) did you notice any unexplained sores or bumps on your (penis/vagina)?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
293	P3_PTX_SYMP3	Before you went to see _______________ (mention provider, clinic or facility name) when you were diagnosed with gonorrhea, did you have any pain or burning when you urinated?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
294	P3_PTX_SYMP4	Did you go to the doctor that time because you were having symptoms or pains you thought might be from an STD
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
295	P3_PTX_Delay	How long did you have these symptoms or pains before you were able to see the doctor?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=1 Day
		2=2 - 6 Days
		3=1 - 2 weeks
		4=More than 2 weeks
		5=Don‘t know / Not sure / Don’t remember
		6=Refused
296	P3_PTX_ExpSTD	Before you went to the doctor that time, did any of your sex partners tell you that you might have been exposed to an STD?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
309	P3_PTX_PartnerTest	Did the doctor, nurse or anyone else during that visit talk to you about the importance of getting your sex partners examined and tested for STDs?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
310	P3_PTX_TellParts	In the time since your visit, did you tell any of your sex partners they may need to tested or treated for STDs?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
311	P3_PTX_EPToffer	Did a doctor, nurse or someone at the health department offer to give you medications or a prescription for you to give to any of your sex partner(s)?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
312	P3_PTX_EPTWHO	Who was it that offered you the additional medications or prescriptions? Was it someone from your doctor’s office or someone from the health department?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=My doctor’s office
		2=The health department
		3=Someone else
		4=Don‘t know / Not sure
		5=Refused
313	P3_PTX_EPTGET	Did you actually get the additional medications or prescriptions for your sex partners?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
314	P3_PTX_EPTMEDORRX	Did you get medicine to give to your partner? Or did you get prescriptions that your partners needed to have filled at a pharmacy?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=I got additional medications
		2=I got prescription(s)
		3=Don‘t know / Not sure
315	P3_PTX_EPTGAVE	Did you give the additional medications or prescriptions to at least one of your sex partners?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		9=Refused
316	P3_PTX_EPTPARTTAKE	Do you think at least one of your sex partners took this medication?
		1=Yes, I think at least one of my partner(s) took this medicine
		2=No, I do not think any of my partner(s) took these medicines
		9=Refused
317	P3_PTX_HIVtested	Did you get tested for HIV at that visit?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
318	P3_PTX_HIVresult	What was the result of your HIV test at that visit?
		This data element should not be ‘null’ or contain missing values if P3_PTX_HIVtested=1.
		1=Positive
		2=Negative
		3=Don't Know / Not Sure / did not get results
		4=Refused
319	P3_PTX_everHIVtst	Have you ever been tested for HIV?
		May be ‘Null’ if P3_PTX_HIVtested=1. This data element should not be ‘null’ or contain missing values for cases responding with 2, 3 or 4 to P3_PTX_HIVtested.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
320	P3_PTX_whenHIVtest	When was your last HIV test? Just month and year is ok? (IF PATIENT UNABLE TO RECALL, PROBE UNTIL APPROXIMATE RESPONSE ELICITED)
		This should be character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or “../….”
321	P3_PTX_HIVeverResult	What was the result of that HIV test?
		This data element should not be ‘null’ or contain missing values for cases responding to P3_PTX_everHIVtst=1.
		1=Positive
		2=Negative
		3=Don't Know / Not Sure / did not get results
		4=Refused
322	P3_PTX_inHIVcare	When was your most recent visit to a doctor, nurse or other health
		This data element should not be ‘null’ or contain missing values for cases identifying as HIV positive (P3_PTX_HIVResult=1 or P3_PTX_HIVeverResult=1). This should be entered as character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or “../….”
323	P3_PTX_ART	Are you taking antiretroviral medicines to treat your HIV infection?
		This data element should not be ‘null’ or contain missing values for cases identifying as HIV positive (P3_PTX_HIVResult=1 or P3_PTX_HIVeverResult=1). This should be entered as character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or “../….”
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
324	P3_PTX_PrEP	When you were diagnosed with gonorrhea, did your health care provider or anyone else discuss medications to help you prevent getting HIV?
		This data element should be ‘null’ for patients reporting being HIV positive. This data element should not be ‘null’ or contain missing values for patients identifying as HIV negative or unknown HIV status.
		0=No, I am already on PrEP
		1=Yes
		2=No
		3= Don‘t know / Not sure
		4=Refused
325	P3_PTX_PREP1	Did your health care provider offer to prescribe or give you
		medications to help you prevent getting HIV?
		This data element should not be ‘null’ or contain missing values if patient reports PrEP.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
326	P3_PTX_PREP2	Did you fill a prescription or get medications to help you prevent getting HIV?
		This data element should not be ‘null’ or contain missing values for those answering “Yes” to P3_PTX_PrEP.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
327	P3_PTX_PREP3	Are you currently taking daily medications to help you prevent
		getting HIV (on PrEP)? This is often called PrEP, or pre-exposure prophylaxis.
		This data element should not be ‘null’ or contain missing values.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
327.1	P3_mpox	Has a doctor or other health care provider ever told you that you had Mpox (monkeypox)? 1=Yes 2=No 3= Don't Know/Not sure/Unknown 4=Refused
327.2	P3_mpox_vax	Have you ever received a vaccine for mpox?
		1=Yes
		2=No (skip to 328)
		3=Don't Know/Not sure/Unknown (skip to 328)
		4=Refused (skip to 328)
327.3	P3_mpox_vaxD	How many doses of vaccine for mpox have you received?
		1=One
		2=Two
		3=Don't Know/Not sure/Unknown
		4=Refused
327.4	P3_mpox_vaxDTE	When was your last mpox vaccine shot?
		This should be character data: ”MM/YYYY”,
		missing/REFUSED information as”../YYYY” or “../….”
328	P3_PTX_Pregnant	Were you pregnant at the time you were told that you had gonorrhea?
		This data element should not be ‘null’ or contain missing value for female cases interviewed. May be null for partial interviews, must be null for male cases.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
329	P3_PTX_GenderSP	During the past 12 months, have you had sex with only males, only females or both?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo) = ‘1’, partial interview.
		1=Males only
		2=Females only
		3=Both Males and Females
		4=Unknown
		9=refused
330	P3_PTX_TGSP	During the past 12 months, have you had sex with a transgender man or transgender woman?
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
331	P3_PTX_Sxorient	Do you consider yourself to be…
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo) = ‘1’, partial interview.
		1=Heterosexual/Straight (not Gay or Lesbian)
		2=Gay/Lesbian/Homosexual
		3=Bisexual
		4=Other/Don't Know
		9=Refused
332	P3_PTX_MaleSPL3MO	Thinking back to the 3 months before you were diagnosed with
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview. Probe for approximate response or ‘best’ guess. Enter 0 to indicate ‘None’, 9999 to indicate “Refused”.
333	P3_PTX_FemaleSPL3MO	Thinking back to the 3 months before you were diagnosed with
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview. Probe for approximate response or ‘best’ guess. Enter 0 to indicate ‘None’, 9999 to indicate “Refused”.
334	P3_PTX_SPtreatOne	To the best of your knowledge, was your sex partner treated?
		This data element is for patient reporting only a single sex partner.
		1=Yes, definitely
		2=Yes, probably
		3=Don't Know / Not Sure
		4=No, probably not
		5=Refused
		6=No need/no partners infected
335	P3_PTX_SPtreatMult	To the best of your knowledge, would you say that all of your sex partners were definitely treated, at least one of your partners was definitely treated, or that none were treated?
		This data element is for patients reporting multiple sex partners.
		1=All definitely treated
		2=At least one definitely treated
		3=At least one probably treated
		4=Not sure
		5=Probably none treated
		6=Refused
		7=No need/no partners infected
336	P3_PTX_SexExch	During the past 12 months, have you given drugs or money in exchange for sex or received drugs or money in exchange for sex? By sex we mean vaginal, oral, or anal sex.
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
337	P3_PTX_Opioid	In the past year, how often have you used prescription pain medications
		other than as prescribed by a doctor?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial interview.
		1=Never
		2=Once or Twice
		3=Monthly
		4=Weekly
		5=Daily or Almost Daily
		9=Refused
338	P3_IVDU	In the past year, have you used any injection drugs such as heroin, cocaine or meth?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
339	P3_IVDU_HER	In the past year, did you inject heroin?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
339.1	P3_IVDU_COC	In the past year, did you inject cocaine/crack?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
339.2	P3_IVDU_MTH	In the past year, did you inject Crystal Meth/Methamphetamine/Methadrone?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
339.3	P3_IVDU_OXY	In the past year, did you inject Oxycodone/morphine/Fentanyl/Carfentanil/some other opioid?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
339.4	P3_IVDU_OTH	In the past year, did you inject other durgs not listed?
		1=Yes
		2=No
		3=Don’t Know/Can’t Remember
		4=Refused
340	P3_IVDU_DR_TX	Other drug injected text.
341	P3_PTX_LastSex	When was the last time you had sex?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=In last week
		2=> 1 week but within last month
		3=> 1 month, but within 2 months
		4=> 2 months ago
		5=Don't Know / Not sure
		9=Refused
342	P3_PTX_GenderMRSP	Thinking back to the last time you had sex, was the person you had sex with…?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=Male (not transgender)
		2=Female (not transgender)
		3=Male-to-Female TG
		4=Female-to-Male TG
		5=TG But Unknown or Unspecified
		6=Queer, Gender Non-binary
		7=Other
		9=Refused or Not Captured
343	P3_PTX_AgeMRSP	Thinking back to the last person you had sex with, how old do you think that person is? If you don’t know for sure, it’s OK to make your best guess.
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
344	P3_PTX_HISPMRSP	Would you say that person is Hispanic/Latino/a? If you don’t know for sure, it’s OK to make your best guess.
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=Yes, Hispanic
		2=No, Not Hispanic
		8=Unknown/Can't guess
		9=Refused
345	P3_PTX_RaceMRSP	Thinking back to the last person you had sex with, what race(s) would you say that person is? If you don’t know for sure, it’s OK to make your best guess.
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=White
		2=Black
		3=AI/AN
		4=ASIAN
		5=NH/OPI
		6=Multiple Races
		7=Unknown/Can't guess
		9=Refused
346	P3_PTX_MRSPHIV	Thinking back to the last person you had sex with, do you know if that person HIV positive?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=Yes, I know that person is HIV positive
		2=No, I know that person is HIV negative
		3=Don't Know /Don't Remember/ Not Sure
		4=Refused
347	P3_PTX_SexAgainMRSP	Thinking back to the last person you had sex with; do you think you will have sex with this person again?
		This data element should not be ‘null’ or contain missing values for interviewed cases. May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
		1=Yes
		2=No
		3=Don't Know /Maybe/ Not Sure
		4=Refused
	Data Element Name	Description/Response Coding
	Laboratory Observation Dataset - sourced from laboratory reporting or case investigations
351	P1_L1_EventID	Unique identifier for associated surveillance record
		Will be a primary key for merging lab and case data; should correspond to P1_EventID. This data element MUST NOT be ‘null’ or contain missing values.
352	P1_L1_LabID	Unique identifier for laboratory performing testing
		Site assigned; may be ID from other system or specifically created for SSuN. If performing lab is not known, site should still create a lab record with a locally defined ID corresponding to unknown lab that they will use throughout the SSuN data collection period. This data element should not be ‘null’ or contain missing values.
353	P1_L1_Accession	Unique identifier (accession number) for laboratory record
		Leave blank (null) if not available/ascertained
353.1	P1_L1_Source	Did this lab record originate from eHARS Match?
		Default code to '0' for lab record NOT from eHARS
354	P1_L1_PatientID	Unique identifier for person (allowing longitudinal tracking of persons)
		Will be a secondary key for merging lab and case data; should correspond to P1_PatientID. This data element MUST NOT be ‘null’ or contain missing values.
355	P1_L1_CondTested	specific condition/pathogen tested
		This data element MUST NOT be ‘null’ or contain missing values.
		1=Syphilis
		2=Gonorrhea
		3=Chlamydia
		4=Genital Herpes
		5=Trichomoniasis
		6=HIV
		7=Hep A
		8=Hep B
		9=Hep C
		10=BV
		11=Other
356	P1_L1_SpecColDte	Specimen collection date - this is often used as a proxy for diagnosis
		This data element should not be ‘null’ or contain missing values. This should be coded as a ‘SAS’ numeric date.
357	P1_L1_LabRepDte	This is the date that the performing lab reported the results to the
		This should be coded as a ‘SAS’ numeric date.
358	P1_L1_SpecType	Type of specimen
		This data element should not be ‘null’ or contain missing values.
		1=Exudate
		2=Blood/sera
		3=Synovial fluid
		4=Urine
		5=CSF
		6=Tissue
		7=Saliva
		8=Other
		9=Unknown
359	P1_L1_AnatSite	This is the anatomic site from which the specimen was obtained and is important in determining the anatomic site of infection.
		This data element should not be ‘null’ or contain missing values.
		1=Urethra
		2=Vagina/cervix
		3=Urine
		4=Rectum
		5=Pharynx
		6=Eye
		7=Sera/Blood
		8=Joint
		9=Other Anatomic Site
		10=Unknown Anatomic Site
360	P1_L1_TestType	As test technology advances, it is important to obtain the type of test performed
		This data element should not be ‘null’ or contain missing values.
		1=Culture
		2=NAAT
		3=Non-amplified nucleic acid test/DNA probe
		4=Gram Stain
		5=DFA
		6=Rapid HIV
		7=ELISA
		8=Western blot (deprecated code, see 27, 28 below)
		9=Pooled RNA
		10=RPR
		11=VDRL
		12=FTA
		13=TP-PA
		14=MHA
		15=Wet Mount/Clue Cell
		16=PH
		17=Other, not listed
		18=Unknown
		22=HIV-1 IA (EIA or Other)
		23=HIV-1/2 IA (EIA or Other)
		24=HIV-2 IA (EIA or Other)
		25=HIV-1/2 Ag/Ab
		26=HIV-1/2 Type-Differentiating Immunoassay
		27=HIV-1 Western Blot
		28=HIV-2 Western Blot
		29=HIV-1 IFA
		30=HIV-1 Culture
		31=HIV-2 Culture
		32=HIV-1 p24 Antigen
		33=HIV-1 RNA/DNA NAAT (Qualitative)
		34=HIV-2 RNA/DNA NAAT (Qualitative)
		35=HIV-1 RNA/DNA NAAT (Quantitative viral load)
		36=HIV-2 RNA/DNA NAAT (Quantitative viral load)
		37=CD4 T-lymphocytes
		38=CD4 Percent
		39=HIV-1 Genotype (PR Nucleotide Sequence)
		40=HIV-1 Genotype (RT Nucleotide Sequence)
		41=HIV-1 Genotype (PR/RT Nucleotide Sequence)
		42=HIV-1 Genotype (IN Nucleotide Sequence)
		43=HIV-1 Genotype (PR/RT/IN Nucleotide Sequence)
		44=STARHS (BED)
		45=STARHS (Vironostika-LS)
		46=STARHS ( BIO-RAD AVIDITY)
		47=STARHS (Other)
		48=STARHS (Unknown)
		49=Rapid (Retired)
		50=HIV-1/2 Ag/Ab-Distinguishing Immunoassay
		51=HIV-1 Genotype (EN Nucleotide Sequence)
		52=HIV-1 Genotype (FI Nucleotide Sequence)
		53=HIV-1/2 Ag/Ab and Type-Differentiating Immunoassay
		54=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 p24 Antigen Analyte
		55=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 Antibody Analyte
		56=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-2 Antibody Analyte
		57=HIV-1/2 Type-Differentiating Immunoassay (Supplemental)
		58=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-1 Antibody Analyte
		59=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-2 Antibody Analyte
		60=HIV-1 Genotype (Unspecified)
		61=WB/IFA-Legacy
		62=RIPA-Legacy
		63=Latex Ag-Legacy
		64=Peptide-Legacy
		65=Rapid-Legacy
		66=Iga-Legacy
		67=IVAP-Legacy
		68=Other HIV Antibody-Other-Legacy
		69=Other HIV Antibody-Unspecified-Legacy
		70=Viral Load-Other-Legacy
		71=Viral Load-Unspecified-Legacy
		72=HIV Detection/Antigen/Viral Load-Other-Legacy
		73=HIV Detection/Antigen/Viral Load-Unspecified-Legacy
		80=Pregnancy
		88= Other
		99=Not captured
361	P1_L1_QualRes	Qualitative result: For most pathogens/tests, positive, negative,
		This data element should not be ‘null’ or contain missing values.
		1=Positive
		2=Negative
		3=Reactive
		4=Weakly Reactive
		5=Non-Reactive
		6=Equivocal/Indeterminate
		7=Specimen Inadequate/Contaminated
		8=Other
		9=Unknown
362	P1_L1_Quantres	Numeric - or Ratio (for RPR/VDRL, e.g. 1:2, 1:4, etc.)
363	P1_L1_QuantUnits	Units for quantitative results:
		1=Copies/mL
		2=Log Copies/mL
		3=Cells/Cubic mm
		4=CD4%
		5=Titer Ratio
		6=Cycles/Time (rtPCR)
	Data Element Name	Description/Response Coding
	Provider Reference Dataset (information should be updated annually)
364	P4_ProvID	Unique identifier for provider/facility
		This data element MUST NOT be ‘null’ or contain missing values.
365	P4_ProvName	Name of provider or facility
366	P4_ProvCO	FIPS code for provider/facility physical location
367	P4_ProvZIP	Facility/provider physical location 5-digit ZIP
		This data element should not be ‘null’ or contain missing values.
368	P4_UpdateDate	Date provider information last updated/verified
		This data element should not be ‘null’ or contain missing values. This
369	P4_LocationLon	Provider physical location longitude
370	P4_LocationLat	Provider physical location latitude
371	P4_CensusTract	Census tract of provider physical location
372	P4_Prov_Fac_Type	Facility or provider type code (PHINVAD compatible)
		This data element MUST NOT be ‘null’ or contain missing values.
		1=Blood Bank
		Includes for-profit sera collection centers
		2=Correctional Facilities
		Includes jails, prisons, juvenile detention, etc.
		3=Day care center (environment)
		4=Dentist
		5=Drug Treatment Facility
		6=Emergency Room/Emergency Department
		Include HMO/other urgent care in this category
		7=Family Planning Facility
		Includes reproductive health clinics
		8=Other Federal Agencies
		Do not include bureau of prisons in this category (should be 2,
		9=HIV Care Facility
		Includes and care facility whose primary service is HIV care
		10=HIV Counseling and Testing Site
		Include HIV outreach & street testing in this category
		11=Hospital - Not ED/ER
		This should include in-patient facilities where the patient was
		12=Labor and Delivery
		13=Laboratory
		14=Managed Care/HMOs
		15=Mental Health Provider
		16=Military
		17=National Job Training Program
		18=Other, not otherwise specified
		19=Other Health Department Clinic
		Do not include health department clinics whose primary
		20=Other State and Local Agencies
		21=Other Treatment Center
		22=Pharmacy
		23=Prenatal/Obstetrics Facility
		24=Private physicians' group office
		25=Public Health Clinic
		Include ONLY public clinics not otherwise categorized
		26=Data/Disease Registries
		27=Rural Health Clinic
		Includes clinics specifically designated as RHCs on the Centers
		28=Categorical STD Clinic
		29=School-Based Clinic
		30=TB Clinic
		31=Tribal Government Clinic
		Do not include IHS hospitals (those are coded as 32)
		32=Indian Health Service
		33=Veterinary Sources
		34=Vital Statistics
		99=unknown
373	P4_ProvCHC	Is facility/provider a Community Health Center (CHC)?
		This data element should not be ‘null’ or contain missing values.
		1=Yes
		2=No
		3=Unknown/Missing
374	P4_ProvFQHC	Is facility/provider a Federally Qualified Health Center (FQHC)?
		This data element should not be ‘null’ or contain missing values.
		1=Yes
		2=No
		3=Unknown/Missing
375	P5_S1SiteID	Site ID
		This 2 character code primarily identifies sites funded under SSuN Cycle 2 & 3 and will include additional sites as required for Cycle 4. This data element MUST NOT be ‘null’ or contain missing values.
		BA=Baltimore (Cycle II, Cycle III, Cycle IV)
		CB=Columbus (Cycle IV)
		CA=California (Cycle II, Cycle III, Cycle IV)
		FL=Florida (Cycle III & Cycle IV)
		IN=Indiana (Cycle IV)
		MC=Multnomah County (Cycle III &Cycle IV)
		NY=New York City (Cycle II, Cycle III, Cycle IV)
		PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
		SF=San Francisco (Cycle II, Cycle III, Cycle IV)
		WA= Washington (Cycle II, Cycle III, Cycle IV)
		UT=UTAH (Cycle IV)
		LA=Louisana (Cycle II)
		VA=Virginia (Cycle II)
		AL=Alabama (Cycle II)
		CO=Colorado (Cycle II)
		CH=Chicago (Cycle II)
		MA=Massachusetts (Cycle III)
		MN=Minnesota (Cycle III)
376	P5_S1EventID	Site generated unique event identifier
		This record ID should be supplied by the site and may be an event or report identifier from underlying surveillance system. Regardless of source, this ID must be unique for each confirmed case report. This data element MUST NOT be ‘null’ or contain missing values. This must match the syphilis record in the Strategy B case file.
377	P5_S1PatientID	Site generated ID allows for longitudinal tracking of unique persons
		This ID should be supplied by the site and may be a unique patient identifier from underlying surveillance systems or may be generated specifically for SSuN from identifying information provided through case reporting. Regardless of source, this ID must be unique and allow for longitudinal tracking of persons reported with multiple episodes of disease. This data element MUST NOT be ‘null’ or contain missing values. This must match the syphilis record in the Strategy B case file.
378	P5_S1PREG_NETSS	Pregnancy status for female syphilis cases
		1=Yes
		2=No
		9=Unknown
379	P5_S1HIVSTAT_NETSS	Documented or self-reported HIV status at the time of event.
		P = HIV positive
		N = HIV negative
		E = Equivocal HIV test
		U = Unknown
		R = Refused to answer
		D = Did not ask
380	P5_S1MSex12_NETSS	Had sex with a male within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
381	P5_S1FSex12_NETSS	Had sex with a female within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
382	P5_S1AnSex12_NETSS	Had sex with an anonymous partner within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
383	P5_S1SxIDU12_NETSS	Had sex with an IVDU within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
384	P5_S1SxINTX12_NETSS	Had sex wwhile intoxicated within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
385	P5_S1SxEX12_NETSS	Exchanged drugs/money for sex within past 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
386	P5_S1SxFMSM12_NETSS	Had sex with MSM in last 12 months (females only)?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
387	P5_S1IVDU12_NETSS	Engaged in injection drug use in last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
388	P5_S1Crack12_NETSS	Used crack last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
389	P5_S1Coke12_NETSS	Used cocaine last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
390	P5_S1Heroin12_NETSS	Used heroin last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
391	P5_S1Meth12_NETSS	Used methamphetamine last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
932	P5_S1Pops12_NETSS	Used poppers/nitrates last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
393	P5_S1EDdru12_NETSS	Used ED drugs last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
394	P5_S1OTHdru12_NETSS	Used other drugs last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
395	P5_S1NOdru12_NETSS	No drug use reported last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
396	P5_S1INCAR12_NETSS	Incarcerated in last 12 months?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
397	P5_S1STIever_NETSS	Does the patient have a history of ever having had an STD prior to the condition reported in this case report?
		Y=Yes
		N=No
		U=Unknown
		R=Refused
398	P5_S1SxInet12_NETSS	Did the patient use an online computer site to exchange messages by typing them onscreen to engage in conversation with other visitors to the site for the purpose of having sex?
		Y=Yes
		N=No
		R=Refused
		D=Did not ask
399	P5_S1TotSP12_NETSS	Total number of sex partners last 12 months (###)
		888=Refused
		999=Unknown
400	P5_S1LSNANUS_NETSS	One or more lesion(s) indicative of syphilis were present in the anus or rectum.
		Y=Yes
		U=Default
401	P5_S1LSNPENIS_NETSS	One or more lesion(s) indicative of syphilis were present on the penis.
		Y=Yes
		U=Default
402	P5_S1LSNSCRO_NETSS	One or more lesion(s) indicative of syphilis were present on the scrotum.
		Y=Yes
		U=Default
403	P5_S1LSNVAGI_NETSS	One or more lesion(s) indicative of syphilis were present on the vagina.
		Y=Yes
		U=Default
404	P5_S1LSNCERV_NETSS	One or more lesion(s) indicative of syphilis were present on the cervix.
		Y=Yes
		U=Default
405	P5_S1LSNPHAR_NETSS	One or more lesion(s) indicative of syphilis were present in the nasopharynx.
		Y=Yes
		U=Default
406	P5_S1LSNORAL_NETSS	One or more lesion(s) indicative of syphilis were present in the mouth/oral cavity.
		Y=Yes
		U=Default
407	P5_S1LSNEYE_NETSS	One or more lesion(s) indicative of syphilis were present in the eye/conjunctiva.
		Y=Yes
		U=Default
408	P5_S1LSNHEAD_NETSS	One or more lesion(s) indicative of syphilis were present on the head.
		Y=Yes
		U=Default
409	P5_S1LSNTORS_NETSS	One or more lesion(s) indicative of syphilis were present on the torso.
		Y=Yes
		U=Default
410	P5_S1NEURO_NETSS	Does the patient have neurologic manifestations of syphilils?
		. = Missing
		1=Yes, Verified
		2=Yes, Likely
		3=Yes, Possible
		4=No
		9=Unknown
411	P5_S1OCULAR_NETSS	Does the patient have ocular manifestations of syphilils?
		. = Missing
		1=Yes, Verified
		2=Yes, Likely
		3=Yes, Possible
		4=No
		9=Unknown
412	P5_S1OTIC_NETSS	Does the patient have otic manifestations of syphilils?
		. = Missing
		1=Yes, Verified
		2=Yes, Likely
		3=Yes, Possible
		4=No
		9=Unknown
413	P5_S1LATE_NETSS	Does the patient have late clinical manifestations of syphilils?
		. = Missing
		1=Yes, Verified
		2=Yes, Likely
		4=No
		9=Unknown
Form Approved
OMB No. 0920-1072
Expiration Date: XX/XX/XXXX

Attachment 5 – Data Elements List OMB Control#0920-1072 58